Published online May 21, 2023. doi: 10.3748/wjg.v29.i19.3003
Peer-review started: February 17, 2023
First decision: March 24, 2023
Revised: March 28, 2023
Accepted: April 24, 2023
Article in press: April 24, 2023
Published online: May 21, 2023
Mother-to-child transmission (MTCT) is the main route of hepatitis B virus (HBV) transmission, and HBV infection is associated with human vitamin D (VD) levels.
The role of VD and single nucleotide polymorphisms of the VD receptor gene (VDR SNPs) in blocking MTCT in pregnant women with high HBV viral load receiving antiviral therapy is unclear.
This study aimed to assess whether baseline VD levels and VDR SNPs are associated with the efficacy of tenofovir disoproxil fumarate (TDF) in the prevention of MTCT in pregnant women with high HBV viral loads.
This retrospective study investigated VD levels, common clinical indicators, and virological parameters before and after antiviral therapy in 38 pregnant women with high HBV viral load, and further analyzed the effect of VD levels and VDR SNPs on the efficacy of TDF for the prevention of MTCT.
The present study showed that a high percentage (76.3%) of pregnant women with high HBV viral loads had deficient (< 20 ng/mL) or insufficient (≥ 20 but < 31 ng/mL) VD levels. There was a profound association between low serum 25-hydroxyvitamin D [25(OH)D] levels and higher levels of maternal HBV replication at delivery after TDF therapy. Multivariate logistic regression analysis showed that baseline serum 25(OH)D levels (OR = 1.23, 95%CI: 1.04-1.44), maternal VDR Cdx2 TT (OR = 0.09, 95%CI: 0.01-0.88) and cholesterol levels at delivery (OR = 0.39, 95%CI: 0.17-0.87) were associated with targeted antiviral effects (maternal HBV DNA levels < 2 × 105 at delivery).
We demonstrate a significant association between low serum levels of 25(OH)D and high levels of HBV replication in pregnant women with high HBV viral loads, and maternal VD levels as well as VDR SNPs may be associated with the efficacy of antiviral therapy.
Future studies to evaluate the therapeutic value of VD and its analogs in reducing the MTCT of HBV may be justified.